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PhD ceremony Ms. I.M. Lako: Depressive symptoms in patients with schizophrenia. Count symptoms that count

When:Fr 22-03-2013 at 16:15

PhD ceremony: Ms. I.M. Lako, 16.15 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: Depressive symptoms in patients with schizophrenia. Count symptoms that count

Promotor(s): prof. K. Taxis, prof. D. Wiersma

Faculty: Mathematics and Natural Sciences

Patients with schizophrenia frequently suffer from co-morbid depressive symptoms. Antidepressants are frequently prescribed and maintained in the treatment of depressive symptoms. In clinical practice, clinicians may have difficulties to adequately distinguish depressive symptoms from other psychotic symptoms in this population. The use of validated depression instruments may help the clinician in the recognition of depressive symptoms. Systematic literature review showed that the Calgary Depression Scale for Schizophrenia (CDSS) is the most reliable and valid depression instrument in this population. We would recommend the clinician to use the CDSS interview for the measurement of depressive symptoms in daily clinical practice of patients with schizophrenia.

Depressive symptoms can be a side effect of antipsychotics. This thesis demonstrated that especially those patients using one or more antipsychotics frequently attributed their depressive symptoms to antipsychotics. A dose-response relationship between depressive symptoms and dopamine D2 receptor occupancy in the brain could, however, not be confirmed in patients using antipsychotic monotherapy. Although this research cannot recommend the use of certain antipsychotic types or doses, we would recommend being cautious with prescribing antipsychotic combination therapy in patients with schizophrenia.

Furthermore, this thesis described the development of the short version of the Subjects’ Response to Antipsychotics (SRA-34) questionnaire, which can be used to evaluate desired and undesired effects of antipsychotics. The short and easy-to-use SR-34 may support the clinician evaluate and address the individual needs of a patient.